Ph II of Capecitabine, Carboplatin & Bevacizumab for Gastroesophageal Junction & Gastric Carcinoma

The recruitment status of this study is unknown because the information has not been verified recently.
Verified September 2012 by Stanford University.
Recruitment status was  Recruiting
Sponsor:
Collaborator:
Genentech, Inc.
Information provided by (Responsible Party):
Pamela L. Kunz, Stanford University
ClinicalTrials.gov Identifier:
NCT00780494
First received: October 23, 2008
Last updated: September 3, 2012
Last verified: September 2012
  Purpose

To investigate bevacizumab in combination with carboplatin and capecitabine for patients with unresectable or metastatic GEJ or gastric cancers. We hope that by adding bevacizumab to standard chemotherapy for this patient population we will improve Progression Free Survival by 80% over historical controls.


Condition Intervention Phase
Stomach Cancer
Gastric (Stomach) Cancer
Neoplasm of Cardioesophageal Junction
Gastrointestinal Stromal Tumor (GIST)
Drug: bevacizumab
Drug: carboplatin
Drug: capecitabine
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase II Study of Capecitabine, Carboplatin, and Bevacizumab for Metastatic or Unresectable Gastroesophageal Junction and Gastric Adenocarcinoma

Resource links provided by NLM:


Further study details as provided by Stanford University:

Primary Outcome Measures:
  • To investigate if the addition of bevacizumab to standard chemotherapy for unresectable and metastatic and GEJ and gastric adenocarcinoma will improve PFS by 90% over historical controls [ Time Frame: CTs to determine time of progression are done every 3 months while on study ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • To assess toxicities using CTCAE v3.0 [ Time Frame: Done at each patient visit, usually Q3wks ] [ Designated as safety issue: Yes ]
  • To evaluate overall survival (OS) using Kaplan-Meier analysis [ Time Frame: Patients are followed until time of death ] [ Designated as safety issue: No ]
  • To evaluate objective response rate (RR) by RECIST criteria [ Time Frame: CTs to determine response rate are done every 3 months while on study ] [ Designated as safety issue: No ]
  • To explore biomarkers of tumor response: CEA, CA 19.9, and serum VEGF [ Time Frame: Done at each patient visit, usually Q3wks ] [ Designated as safety issue: No ]
  • To bank serum and tissue for future correlative studies [ Time Frame: Done at each patient visit, usually Q3wks ] [ Designated as safety issue: No ]

Estimated Enrollment: 35
Study Start Date: February 2009
Estimated Study Completion Date: April 2014
Estimated Primary Completion Date: April 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: bevacizumab in combination with carboplatin and capecitabine Drug: bevacizumab
IV 15 mg/kg
Other Name: Avastin
Drug: carboplatin
AUC 6, Intravenously Day 1 every 21 days
Other Name: Paraplatin
Drug: capecitabine
850mg/m2, Orally twice daily days 1-14 every 21 days.
Other Name: Xeloda

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Subjects must be treated at Stanford University Medical Center for the entire length of study participation.

  1. Patients with histologically or cytologically confirmed adenocarcinoma of the GEJ or stomach.
  2. Patients must be deemed unresectable due to involvement of critical vasculature or adjacent organ invasion. If unresectable, patients must show evidence of disease progression prior to enrollment.
  3. Patients with prior surgical resection who develop radiological or clinical evidence of metastatic cancer do not require separate histological or cytological confirmation of metastatic disease unless an interval of > 5 years has elapsed between the primary surgery and the development of metastatic disease. Clinicians should consider biopsy of lesions to establish diagnosis of metastatic disease if there is substantial clinical ambiguity regarding the nature or source of apparent metastases.
  4. Prior carboplatin as neoadjuvant or adjuvant therapy will be allowed if >= 6 months from the time of study entry.
  5. If patients use aspirin (>325mg/day) or NSAIDS at the time of enrollment, they must have a 10 day washout period prior to beginning protocol treatment.
  6. Low molecular weight heparin (or its equivalent, excluding warfarin) will be allowed for treatment of venous thromboembolic events if patients have no evidence of bleeding on full-dose anticoagulation.
  7. Patients must have a primary or metastatic lesion measurable in at least one dimension by Modified RECIST criteria (see Section 11.2.3) within 4 weeks prior to entry of study
  8. Patients must have ECOG performance status of 0-1
  9. Patients must be >= 18 years of age
  10. Laboratory values <= 2 weeks prior to randomization:

    • Absolute Neutrophil Count (ANC) >= 1.5 x 109/L (>= 1500/mm3)
    • Platelets (PLT) >= 100 x 109/L (>= 100,000/mm3)
    • Hemoglobin (Hgb) >= 9 g/dL
    • Serum creatinine <= 1.5 x ULN
    • Serum bilirubin <= 1.5 x ULN (<= 3.0 x ULN if liver metastases present)
    • Aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT) <= 3.0 x ULN (<= 5.0 x ULN if liver metastases present). Note: ERCP or percutaneous stenting may be used to normalize the liver function tests.
  11. Life expectancy >= 12 weeks
  12. Inclusion and exclusion criteria for DCE-MRI and DWI imaging will be determined by CT scan as part of routine post-chemotherapy imaging. Subjects will be eligible if one liver metastasis is greater than 1 cm in size. Participation in the DCE-MRI and DWI correlate is not required for eligibility.
  13. Ability to give written informed consent according to local guidelines

Exclusion Criteria:

  1. Disease-Specific Exclusions

    1. Prior chemotherapy for metastatic disease
    2. Prior full field radiotherapy <= 4 weeks or limited field radiotherapy <= 2 weeks prior to enrollment. Patients must have recovered from all therapy-related toxicities. The site of previous radiotherapy should have evidence of progressive disease if this is the only site of disease.
    3. Prior biologic or immunotherapy <= 2 weeks prior to registration. Patients must have recovered from all therapy-related toxicities
    4. Prior therapy with anti-VEGF agents
    5. If history of other primary cancer, subject eligible only if she or he has:

      • Curatively resected non-melanomatous skin cancer
      • Curatively treated cervical carcinoma in situ
      • Other primary solid tumor curatively treated with no known active disease present and no treatment administered for the last 3 years
    6. Concurrent use of other investigational agents and patients who have received investigational drugs <= 4 weeks prior to enrollment.
    7. Hypersensitivity to capecitabine, fluorouracil, or any component of the formulation and or a known deficiency of dihydropyrimidine dehydrogenase.
  2. General Medical Exclusions

    1. Subjects known to have chronic or active hepatitis B or C infection
    2. History of any medical or psychiatric condition or laboratory abnormality that in the opinion of the investigator may increase the risks associated with study participation or study drug administration or may interfere with the conduct of the study or interpretation of study results
    3. Male subject who is not willing to use adequate contraception upon enrollment into this study and for 6 months following the last dose of second-line treatment
    4. Female subject (of childbearing potential, post-menopausal for less than 6 months, not surgically sterilized, or not abstinent) who is not willing to use an oral, patch or implanted contraceptive, double-barrier birth control, or an IUD during the course of the study and for 6 months following the last dose of second-line treatment
    5. Female subject who is breast-feeding or who has positive serum pregnancy test 72 hours prior to randomization
    6. Pleural effusion or ascites that causes respiratory compromise (>= CTCAE grade 2 dyspnea)
    7. Any of the following concurrent severe and/or uncontrolled medical conditions within 24 weeks of enrollment which could compromise participation in the study:

      • Unstable angina pectoris
      • Symptomatic congestive heart failure
      • Myocardial infarction <= 6 months prior to registration and/or randomization
      • Serious uncontrolled cardiac arrhythmia
      • Uncontrolled diabetes
      • Active or uncontrolled infection
      • Interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung.
      • Chronic renal disease
      • Acute or chronic liver disease (e.g., hepatitis, cirrhosis)
    8. Patients unwilling to or unable to comply with the protocol
    9. Life expectancy of less than 12 weeks
    10. Current, recent (within 4 weeks of the first infusion of this study), or planned participation in an experimental drug study other than a Genentech-sponsored bevacizumab cancer study
  3. Bevacizumab-Specific Exclusions

    1. Inadequately controlled hypertension (defined as systolic blood pressure >150 and/or diastolic blood pressure > 100 mmHg on antihypertensive medications)
    2. Any prior history of hypertensive crisis or hypertensive encephalopathy
    3. New York Heart Association (NYHA) Grade II or greater congestive heart failure (see Appendix A)
    4. History of myocardial infarction or unstable angina within 6 months prior to study enrollment
    5. History of stroke or transient ischemic attack within 6 months prior to study enrollment
    6. Known CNS disease, brain metastases.
    7. Significant vascular disease (e.g., aortic aneurysm, aortic dissection)
    8. Symptomatic peripheral vascular disease
    9. Evidence of bleeding diathesis or coagulopathy
    10. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study enrollment or anticipation of need for major surgical procedure during the course of the study
    11. Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to study enrollment
    12. History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrollment
    13. Serious, non-healing wound, ulcer, or bone fracture
    14. Urine protein >= 2+ on urinalysis dipstick and >= 1.0 gram on 24-hour urine collection
    15. Known hypersensitivity to any component of bevacizumab
    16. History of hemoptysis (bright red blood of ½ teaspoon or more per episode) within 3 months prior to study enrollment.
    17. Current, ongoing treatment with full-dose warfarin.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00780494

Contacts
Contact: Prachi Nandoskar 650-725-0438 prachin@stanford.edu

Locations
United States, California
Stanford University School of Medicine Recruiting
Stanford, California, United States, 94305
Contact: Prachi Nandoskar    650-725-0438    prachin@stanford.edu   
Contact: Cancer Clinical Trials Office    (650) 498-7061      
Sub-Investigator: George Albert Fisher M.D. Ph.D.         
Sub-Investigator: James M Ford         
Principal Investigator: Pamela Kunz         
Sponsors and Collaborators
Pamela L. Kunz
Genentech, Inc.
Investigators
Principal Investigator: Pamela Kunz, MD Stanford University
  More Information

No publications provided

Responsible Party: Pamela L. Kunz, Asst Prof-Med Ctr Line, Stanford University
ClinicalTrials.gov Identifier: NCT00780494     History of Changes
Other Study ID Numbers: GI0002, 98587, SU-07082008-1238
Study First Received: October 23, 2008
Last Updated: September 3, 2012
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Additional relevant MeSH terms:
Gastrointestinal Stromal Tumors
Stomach Neoplasms
Digestive System Diseases
Digestive System Neoplasms
Gastrointestinal Diseases
Gastrointestinal Neoplasms
Neoplasms
Neoplasms by Histologic Type
Neoplasms by Site
Neoplasms, Connective and Soft Tissue
Neoplasms, Connective Tissue
Stomach Diseases
Bevacizumab
Capecitabine
Carboplatin
Fluorouracil
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Antimetabolites
Antimetabolites, Antineoplastic
Antineoplastic Agents
Growth Inhibitors
Growth Substances
Immunologic Factors
Immunosuppressive Agents
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Therapeutic Uses

ClinicalTrials.gov processed this record on October 23, 2014